South Africa is poised to make significant strides in its fight against HIV with the impending introduction of lenacapavir, a groundbreaking long-acting injectable prevention method. This innovative drug offers six months of protection with just two doses annually, promising enhanced consistency in prevention by eliminating the need for daily pills or frequent clinic visits. Dr. Aaron Motsoaledi, the Health Minister, confirmed that the initial phase of the lenacapavir rollout is scheduled to commence in South Africa in March or April 2026, contingent upon the efficient coordination of logistics between the government and its partners. This timeline was discussed during a roundtable event with the South African National Aids Council, which focused on assessing the readiness for the drug's administration at both provincial and district levels.

The lenacapavir rollout strategy in South Africa will prioritize 23 high-incident districts across six provinces. Distribution will be facilitated through approximately 360 high-capacity public clinics, ensuring targeted access for the most vulnerable populations. Initial access will be granted to pregnant and breastfeeding women, adolescent girls, sex workers, and men who have sex with men, groups historically identified as being at higher risk of new infections. Clinical trials for lenacapavir have shown remarkable efficacy, reporting 100% protection among women and 96% among men who have sex with other men and transgender women, cementing its reputation as one of the most promising prevention tools developed to date.

Crucially, financial backing for this ambitious rollout has been secured through the PEPFAR Bridge Plan for South Africa. The United States government approved this plan, unlocking US$115 million (approximately R2.1 billion) to sustain essential HIV services. This vital funding will cover the period from October 1, 2025, to March 31, 2026, following a prior freezing of global foreign aid funding by the US government earlier in the year. Minister in the Presidency, Khumbudzo Ntshavheni, welcomed this development during a media briefing on October 16, 2025.

With both innovative prevention and crucial funding now in place, the South African government faces the pressing challenge of synchronizing clinical readiness, public communication campaigns, and supply chains. South Africa has set an ambitious national goal to reduce new HIV infections to below 0.1% by 2032. Health officials are optimistic that if two to four million people gain access to lenacapavir within its first two years of availability, the country could achieve near-elimination of new HIV infections, marking a pivotal moment in its public health efforts.